An estimated 5.5 million adults in the United States use hallucinogenic drugs. People who take hallucinogens may be hoping to escape their lives, reset their brains or have new experiences. While the drugs may provide these benefits, they can also cause side effects, including hallucinogen persisting perception disorder or HPPD. Read on to learn more about this disorder and what can be done to treat it.
What Is HPPD?
HPPD disorder is a mental health condition that arises after the use of hallucinogenic drugs, typically lysergic acid diethylamide. Also known as LSD, this drug is a clear or white material derived from a fungus that grows on grains. It causes people to see images and feel sensations that aren’t real, called hallucinations.
In people with HPPD, some of the experiences that occurred while taking hallucinogens reoccur even when they’re not intoxicated. The word hallucinogen in the name of the condition refers to the fact that people with the condition hallucinate, while persisting perception disorder describes how these symptoms persist beyond the high associated with the drugs.
There are two types of HPPD: Type 1 and Type 2. With Type 1, symptoms occur at random for a few months after initial drug use. Some people refer to these short-lived symptoms as flashbacks. If you have Type 2 HPPD, the symptoms become chronic and reoccur for years. Most individuals with Type 2 have symptoms on and off, and the intensity of their flashbacks may vary.
What Are the Symptoms of HPPD?
Most symptoms of HPPD are visual hallucinations. Some HPPD vision symptoms include:
- Colors appearing brighter or more vivid than they are
- Seeing flashes of color in your field of vision
- Temporary color blindness or not being able to tell colors apart
- Distortions in the perceived size of objects that make things seem larger or smaller
- Perceiving glowing rims or halos around objects
- Objects or people leaving trails or tracers as they move
- Viewing geometric patterns like a checkerboard over top of objects
- Spotting images inside of other images that others don’t see
Individuals with HPPD may struggle with reading. Words may move or shake, or letters may become scrambled or bunched up on signs, pages and screens. Some people also develop feelings of uneasiness or anxiety along with HPPD vision symptoms. In extreme cases, anxiety can trigger panic attacks, causing symptoms such as:
- Shaking and trembling
- Nausea
- Rapid and/or irregular heartbeat
- Breathlessness
- Dizziness
- Sweating
- Dry mouth
- Chest pain
- Feeling of impending doom or danger
What Are the Causes and Risk Factors for HPPD?
HPPD is very rare. Most people who take hallucinogens don’t develop it. Because the condition affects only a small number of people, there’s much we don’t understand about HPPD.
One theory is that taking hallucinogens changes the way the brain processes visual information, causing it to see things incorrectly or superimpose colors, patterns and images over things that exist in the environment. The alterations in brain activity may be due to shifts in levels of the brain chemical gamma-aminobutyric acid or GABA.
As a neurotransmitter, GABA is responsible for calming the nervous system and stopping nerve signaling. When the body has too much or too little GABA, the nerves responsible for capturing and interpreting information gathered by the eyes may not work properly.
The primary risk factor for HPPD disorder is using LSD and other hallucinogenic drugs. Stress and fatigue may worsen symptoms.
What Are the Diagnostic Criteria for HPPD?
A person may be diagnosed with HPPD if all the following are true:
- They’re reexperiencing visual effects and other symptoms that they experienced while taking hallucinogenic drugs.
- The symptoms cause emotional distress and/or interfere with their daily activities, work or relationships.
- There’s no underlying medical condition or mental health condition that could be causing the symptoms.
What Does Treatment for HPPD Involve?
Most often, treatment for HPPD involves prescription medications, including:
- Alpha-2 adrenoceptors: Drugs that limit the release of certain brain chemicals, including clonidine and guanabenz
- Benzodiazepines: Drugs that reduce central nervous system activity to relieve anxiety
- Naltrexone: Used to treat substance use disorder
- Anticonvulsants: Drugs that alter electrical activity in the brain, such as lamotrigine
People may need to try different medications to find the one that works best for controlling symptoms or take more than one medication to get relief.
In addition to medication, mental health professionals frequently recommend talk therapy as a treatment for HPPD. Therapy can help people with the disorder learn to manage stress and develop coping strategies for dealing with HPPD vision symptoms.
How Can People With HPPD Disorder and Their Families Cope With the Condition?
Individuals with HPPD don’t know when symptoms may return. As a result, it’s important to develop a plan of action to respond when they do.
Learning relaxation techniques like deep breathing or mindfulness exercises can help those with HPPD disorder remain more in control when flashbacks occur. Taking steps to manage stress through exercise, enjoying hobbies, socializing with others, listening to music and engaging in other activities may help reduce the frequency of flare-ups.
If HPPD affects performance at work or school, people with the condition can seek accommodations. For example, they may use audiobooks or text-to-speech software if reading is difficult. Apps for people with dyslexia may also be beneficial for those who have difficulty reading due to HPPD.
Loved ones of individuals with HPPD are an important source of support. They may feel angry with the individual for using drugs and benefit from individual or family talk therapy with a mental health professional to work through their emotions.
When the person with HPPD experiences a flashback, loved ones can help them feel safe and remind them that symptoms are temporary. They can also ensure that the HPPD vision symptoms don’t put the person’s safety at risk.
Following episodes, loved ones can help simply by being willing to listen. Talking about the experiences can help a person with HPPD process their own feelings and may reduce anxiety and stress about having the condition.
Hope for Those With HPPD
Although there’s no cure for the condition, treatment for HPPD can reduce symptoms and help people with the disorder lead fuller lives. FHE Health offers inpatient and outpatient treatment options that can help you or your loved one learn to cope with HPPD disorder. Contact us today to learn more.
